Last year, when the preface to the annual report for 2019 was written, we knew little about covid-19. Our ambition for 2020 was to put pharmacies on the Norwegian health policy agenda, and we had several strategies to further develop the pharmacies.
On March 12, Norway was suddenly shut down, and the pandemic has largely affected the rest of the year. It hit the pharmacies too. For a while, it was a crisis mood and hoarding. The medicine cabinets were to be filled in the thousands of homes. Several vital medicines were rationalized.
Luckily it all calmed down quickly, and it became possible to act. The pharmacy association took a coordination role and was constantly in contact with the authorities and our members. Like many other sectors and industries, there were no crisis plan suitable for the pandemic situation. Infection control, practical questions, communication internally and externally. A lot had to be made up along the way. But the pharmacy sector landed on its feet, and that with style.
In general, the pharmacy turnover, number of customers and drug use were relatively unaffected. The pharmacies managed to stay open in a challenging time and ensured safe distribution of medicines and provided good advice and service. They deserve great credit for that!
However, 2020 was not only a pandemic year for the pharmacy sector. In September, the pharmacists were given the right to order flu vaccines, something we have been working to achieve for several years. This increased the possibilities to get vaccinated. The pharmacies put a record number of flu vaccines through the autumn. 100,000 people in the risk groups took advantage of the opportunity.
The development of a more digital health services goes fast, and we used 2020 to establish pharmacies as a central player in the e-health arena. Quickly, we gained access to the authorities' central governing bodies, a position that gives us new opportunities. The development of a new pharmacy IT-system was also in the final phase at the end of the year.
Although 2020 have been a good year for the pharmacy economy, regulations still need to be improved. Therefore, it is positive that the Norwegian Parliament in the autumn of 2020 asked the Ministry of Health to consider an annual price adjustment for the pharmacy services. A good start is that the tariffs for guidance services in pharmacies will be price-adjusted from 2021.
Last year showed a pharmacy industry that collaborates well, even under pressure, to find the best solutions for its customers. It has also shown that the pharmacies copes with normal operations at the same time as it adjusts to cope with the unforeseen.
Per T. Lund, CEO
5 450 inhabitants per pharmacy
In total 54,5 million client visits
Among these 3754 are pharmacists
New webpage for Pharmacy and Medicine Statistics
For manye yeras, the Pharmacy Association has published the booklet "Pharmacy and medicines". From 2020, the statistics are presented in a new way on apotek.no, and the statistics pages have become more dynamic.
On 31st of August, it was finally decided that pharmacists can order flu vaccines, without a doctor’s prescription. The new section 2-4, second paragraph, of the Requisition and Delivery from Pharmacies Regulations reads as follows:
Pharmacists working in pharmacies can order vaccines against seasonal flu to be administered in the pharmacy. The right of prescription also includes medicines that are necessary for the administration of the vaccine. Pharmacy owners do not have the right to requisition. The Norwegian Directorate of Health may issue further guidelines for medicinal products which may be ordered in accordance with this subsection.
By the end of the year, more than 30,000 consultations concerning new medicines had been made. This is an increase by 44 percent from 2019. “New Medicine Service” has continued to be a popular service through the pandemic because the pharmacists were able to do it by phone.
Most of the conversations are about motivating the patient to use their new medicine. Discussing concerns and give advice on side effects are also part of the consultations. The medicine Atorvastatin were most often discussed in the conversations, but also Metoprolol, Apixaban and Amlodipine were discussed.
In 2020, there was a decrease in the number of inhalation-technique guidance by 16 percent. It has been possible to carry out this service in the pharmacy, but strict infection control measures explain the decline compared to the previous year. However, with over 62,000 inhalation instructions, the pharmacies show that they manage to deliver the service in a good way in a demanding time.
Despite the authorities' decision to prioritize flu vaccines to risk groups, the interest in taking the flu vaccine in pharmacies has been record high. In 2020, around 900 pharmacies have administered more than 100,000 influenza vaccines, compared with almost 33,000 influenza vaccines in 2019. The pharmacies have increased access to influenza vaccines for the Norwegian population by 20 per cent. Of the nearly 100,000 vaccines in pharmacies, 77,000 were ordered by a pharmacist.
In 2020, there have also been several shortage situations in pharmacies. During the first months of the pandemic, some medicines were also rationed to avoid future shortage situations. In 2019, the Norwegian Directorate of Health recommended 29 measures to improve national drug preparedness. One of the measures was the common standard for handling drug shortages in pharmacies. The Pharmacy Association, in collaboration with the pharmacy chains, has prepared a Standard for handling drug shortages in pharmacies.
The standard shall contribute to maintaining the customer's drug treatment in the event of a drug shortage, as well as good and equal impact assessment and treatment of customers who experience a drug shortage in a pharmacy. “Apokus” has, in collaboration with the Pharmacy Association, made an e-learning course on dealing with drug shortages in pharmacies.
The Pharmacy Association has analyzed the development of the pharmacy profit in the report "Pharmacies' profit on prescription drugs" which was presented on 16 September. The analyzes show that the pharmacies' profit margin has fallen sharply from 2016 to 2019.
The Pharmacy Association claims the pharmacy surplus should be more sustainable and comes following recommendations to the authorities: price-adjust the krone surcharges in the pharmacy surplus, price-adjust the step prices, abolish the drug retailer fee, introduce a minimum price for step-price medicines and adjust labor prices in pharmacies.
In 2020, the Pharmacy Association has worked to promote the pharmacies' interests in technology and e-health by creating a closer collaboration with national e-health authorities and relevant interest organizations. In August, a separate Position Document for e-health was launched, based on the Pharmacy Association's position document from 2019.
The position document has been prepared in close collaboration with the association's members, at the same time input has been obtained from the authorities and interest groups. The purpose of the document is to state the strategic position and goals for the e-health work of the Pharmacy Association, and how e-health will support the work of securing patient-oriented pharmacies in the future.
The collaboration on the common pharmacy IT-system Eik is an important prerequisite for being able to adapt to digital development. Eik will facilitate communication with public systems and registers, as well as improve the digital interaction between pharmacies. With Eik, the information will be following the patient and pharmacy employees can use the information as a basis for health care across the pharmacies. In this way, patients will receive equal treatment regardless of where they are located. The new system will be deployed to the pharmacies during late 2021 and through 2022.
Student Practice in pharmacies
The Pharmacy Association's practice pool annually provides internships in pharmacies for pharmacy students at the Universities of Oslo, Bergen and Tromsø, OsloMet and NORD University. As of 2020, the allocation has taken place through a new digital platform and this year's elections were carried out as planned. The coordinators, chain contacts, pharmacies and students are very satisfied and experience a great simplification of the process.
Education + work
The Pharmacy Association is concerned with continued education and how the pharmacy employees can further develop their competence. The subsidiary, Apokus, which is the pharmacies 'competence and development center, develops training programs and carries out development projects with the aim of further developing the pharmacies' services for the benefit of the drug user. In 2020, the Pharmacy Association has, ordered training courses (eg e-learning courses on influenza), and various research and development projects (eg evaluation of the start of medicine) from Apokus.